1. Self-Organized Software Platform(SOSp)-based Mobile chronic disease management Do-Youn Lee l, Joon Hyun Song l, Sung-Hyun Lee', Jong-Ho Lim l, Set-Byeol Park', Yoon, Yeohoon l, Byoung-kee Yi 2, Il Kon Kim 1 1 Kyungpook National University Daegu, Republic of Korea 2 Department of Medical informatics Samsung Medical Center Seoul, South Korea Correspondence: keveni@naver.com Abstract. In modem society, aging and chronic disease is becoming increasingly common due to the increasing numbers of elderly patients. To best treat this growing segment of the population, medical care should be based on constant vital sign monitoring. In this study, we propose a mobile vital sign measurement and data collection system for chronic disease management, and we propose medical services with a self-organized software platform. Keywords :L7, CDA,U-Health, Self-organization, Chronic Disease, Mobile Vi-tal Signs, Context-aware, Opportunistic Computing 1 Introduction In modern society there is an increasing number of people with bad eating habits who do little physical activity. These people have been experiencing an increase in life-style- related disease. Also, there is a growing number of elderly people with chronic disease as well. Despite the development of medical technology, successful treatment rates of chronic disease are significantly low. The failure of the management of chronic disease causes complications that lower the quality of life, increase the eco-nomic burden, and create social problems. Most chronic diseases can only be cured by active self-management based on a doctor's guiding advice. But if a hospital's medical services can take a more active role in long- term management of chronic disease, it would be possible to maximize therapeutic effects. In order to do that, a patient's biological signals must be measured at all times and instantly transmitted to medical personnel [6]. To implement this type of comprehensive patient monitoring system would be a joint effort between companies and public agencies. They would have to work together with hospitals to provide equipment and home facilities. The raw biometric data from the patient must be identified and filtered before being sent to the medical institution. Creating personal devices to gather patient information is not really a problem This work was supported by the IT R&D program of MKE/KEIT. [10041145, Self- Organized Software-platform(SOS) for welfare devices] Session 4A 413 http://www.mercubuana.ac.id

2. in this scenario. The problem comes from many users using many devices at the same time, and the huge flow of information that would represent. There is also the consideration of the quality of data collected outside the hospital. Some devices now do not create data that conforms to international medical standards, and so medical workers cannot take full advantage of it. In that case, medical workers find it difficult to give feedback to the patient. In this study, we propose a mobile chronic disease management system using a self-organized software platform (SOSP) and implementing international standards to ensure the interoperability of a comprehensive and convenient health information architecture. 2 Backgrounds 2. 1 H L 7 HL7 refers to an application protocol for electronic data exchange in healthcare envi- ronments. It is based on the XML-based message format, and standardization is al- ready ongoing in Korea. It is part of the Electronic Medical Records (EMR) standard, which is increasingly being recognized [1]. 2.2 Self-Organization Self-organization is a process in which structure and functionality (pattern) at the global level of a system emerge solely from numerous interactions among the lower-level components of a system without any external or centralized control. The system's components interact in a local context either by means of direct communication of environmental observations without reference to the global pattern [4]. 2.3 Self-Organized Software Platform Development of a SOSP is a national project at Kyungpook National University in South Korea. This project goal is specifically the development of a SOSP that connects disparate health monitoring devices. Also it aims for the development of a reference platform based on SOSP. A description of the SOSP concept is given below. Self-Organized Swarm Intelligence Context-Aware K Opportunistic Computing Self-Organized Software : SOSp tit Fig. 1. Concept of self-organized software platform. 414 Computers, Networks, Systems, and Industrial Appications

3. SOSPs have three essential features, which are named Opportunistic Computing, Context-awareness, and Self-Organized Swarm Intelligence. SOSP clients attempt to connect to other SOSP devices within a reachable distance. This also makes it possible for a device to capture both a user's biometric and information on the surrounding environment [3]. In this study we focus on a device that can measure vital signs and also perform as part of a SOSP, in order to carry out effective chronic disease management. 3 Self-Organized Software Platform-based Mobile Chronic Disease Management 3.1 Existing chronic disease management U-Health System - Health Device Data U-Health Gateway Health Device - HL7 Message - HL7 CDA Document U-Health Server Patient 14'a Medical Team - PCWEBUI I 1 Fig. 2. Existing chronic disease management U-Health system Existing chronic disease management U-Health Systems need patient authentication before collecting a patient's vital signs (Fig. 2). This is a very cumbersome and the cause of confusion in an environment that uses a lot of patient authentication. Also if the patient don't authenticate, the measured data does not get not transferred to the medical worker, which makes diagnosis more difficult. This will lower healthcare service quality [7]. 3.2 Mobile Chronic Disease Management Architecture based on Self-Organized Software Platform Unlike existing U-health systems, the SOSP client authenticates for the patient auto- matically, reducing hassles. All the measured data is recorded on the server. This Session 4A 415 http://www.mercubuana.ac.id

4. means that medical workers always have the necessary data for diagnosis, which means that they can provide higher quality healthcare services. V S ) - Health Device - Health Device Data Data & Patient ID Health Device SOSp Router SOSp Client (Medical Watch) - HL7 Message - HL7 CDA Document 4a, Medical Team U -Heath Server  PC Web UI  Mobile Web UI Patient Fig. 3. SOSP-based mobile chronic disease management. 3.3 SOSP-based Mobile Chronic Disease Management Structure 3.3.1 Measuring Vital Signs with SOSP Client Many vital sign measurement devices do not observe international standards for med-ical data in many cases, and also often do not include patient information. This ham-pers the interoperability of said devices. We designed the necessary structure to trans-form patient information and vital signs into the HL7 V2.5 international standard message format in order to maximize interoperability [1, 2, 5, 7]. The data that is captured through devices is transmitted to the SOSP client and in- tegrated with the rest of the patient's information. Then it is transmitted to the SOSP router. If there is no SOSP router or SOSP client that is connected with an SOSP rout-er, the measurement information is stored until one can be found using the self-organizing network (Fig. 3). 3.3.2 SOSP Router An SOSP router receives integrated data from an SOSP client, converts the data to an HL7 2.5 message, and transfers that message to a u-health message server. PCD-01 according to the received data is converted into an ORO RO1 message, which is then transmitted. The transmission uses any wired or wireless network [1, 2]. 3.3.3 U-Health Message Server The SOSP server extracts the medical data from the HL7 V2.5 message. The server compares the extracted data with the stored data. They must match in patient ID and other data before being committed, to make sure that the data is something that the medical workers can use [1]. 416 Computers, Networks, Systems, and Industrial Appications

5. 3.3.4 Use of U-Health Data Data stored on the server must be available through the Internet. Confirmation that patient records have been measured at any time and general access is possible using a PC or smartphone. Medical workers will check the document that matches up with the HL7 Clinical Document Architecture to diagnose a patient [1]. 4 Medical Records System with Integrated Utilization In order for SOSP to combine chronic disease management, hospital and personal health management, several changes must occur. 4.1 SOSP-based Improved Prescription and Payment Services Fig. 4. SOSP-based improved prescription and payment services. When patients visit a hospital, they normally get care in the order in which they ar- rived. Even if patients have an appointment they often have to wait before getting treated. After they receive a medical examination, patients must pay the bill and often receive a prescription. Patients must often go to the pharmacy in order to pick up the medication that they need, which requires further payment. This procedure can be greatly simplified with SOSP. If the patient has an SOSP client, they would not have to wait to register for treatment. Medical treatment can automatically be scheduled. Their on-file billing information can be used to automati- cally take care of payment for the treatment and the medication both. The only thing a patient would have to do is travel to the hospital and then the pharmacy. When the patient enters the pharmacy, their identifying information can be transferred to a serv- er. The pharmacist can receive all the information he requires and help the patient immediately (Fig.4). 4.2 SOSP Service - Chronic Disease Management Vital signs and user activity can be measured and recorded in an SOSP environment. If a patient exercises, the SOSP client can collect data about the user and the envi- Hosptal visit Transfer Patient ID, prescriptic Hospital Receive treatment P r e s c r iption= sansferred L _ - Generated prescription L Pharmacy Visit Make up a Prescription Session 4A417

6. ronment in which the user is exercising like current temperature, exercise time, heart rate, and blood pressure (Fig. 5). Based on the data collected, patients will be able to receive high-quality feedback from the SOSP client and excellent advice from health professionals [3]. Fig. 5. Chronic disease management related directly with the SOSP service 4.3 Chronic Disease Management Services with Mobile SOSP Fig. 6. A diagram of the envisioned chronic disease management service with an SOSP client. Even if you don't have a router, you can build an SOSP environment with a wireless Internet device and an SOSP router dongle. Just by installing the routing software from the dongle (Fig.6), you can establish a low-cost SOSP environment, and the leverage of the total network will be increased [3, 6]. Personal users can build an SOSP environment using an SOSP dongle. Patients who visit health care services can record vital signs information with the SOSP smartphone environment. 5 Conclusion In this study, we designed a mobile SOSP-based chronic disease management archi- tecture based on the existing chronic disease u-health system. In particular, the ap- proach was to improve on limitations of the current u-health system. - Patient Information Transfer t o Server H 418 Computers, Networks, Systems, and Industrial Appications

7. In the existing u-health system, users must authenticate before measuring vital signs, and that bothers patients a lot. But if they don't authenticate the measurement data cannot be used. This problem is solved by the SOSP environment. Also, the data can be accessed by mobile web UI services, which greatly improves the ability to utilize information. SOSP combines existing systems. It connects local devices and the natural envi- ronment. It is context-aware, fully decentralized, and autonomous. It consists of three elements. This technology has become an autonomous community software platform combining existing systems, which makes a big difference. In the past, a patient's biometric information was limited due to security problems, and there was a lot of difficulty in providing medical guidance. However, in this new u- health and SOSP age, communication between devices, medical professionals, and patients can be greatly sped up to give more accurate and comfortable treatment of chronic disease. The SOSP client is always aware of its environment and the person it is monitoring. The doctor is always able to determine the current status and location of the patient, and the hospital can always respond appropriately in emergency situations. SOSP is a fully-decentralized and autonomous community that can preserve and transmit data without any losses. Based on the data thus obtained, accurate treatment of chronic diseases can be done, and patients can live longer. It is still not implemented yet, because there are still many requirements to create a functional SOSP situation. In the future, though, the necessary infrastructure will be constructed, such as chronic disease management services, mobile SOSP services that can be used in this situation, and other medical services can be adjusted to account for SOSP abilities. The medical community should be fully prepared for this type of envi- ronment. Reference 1.Health Leven Seven International,http://www.hl7.org 2.Integrating the Healthcare Enterprise,http://www.ihe.net 3.Center of Self-Organizing Software-Platform,http://csos.knu.ac.kr 4.Giovanna Di Marzo Serugendo, Marie-Pierre Gleizes, Anthony Karageorgos.: Self-organising Software: From Natural to Artificial Adaptation(2011) 5.H. J. Hwang, J.T. Choi, Application Framework for Improving Interoperability in u-health service: The Journal of Korean Institute of Information Technology vol. 8,2010.5, pp. 111-118(2010) 6.H. S. Kim, J. H. Jo, Y. H. Choi, J. A. Oh, J. H. Lee, G. H. Yun, Ubiquitous Health Care system for Chronic disease management: Korea Information and Communications Socie- ty, Vol 27,2010.9, pp 3 --8 7.S. H. Lee, J. H. Song, J. H. Ye, H. J. Lee, B. K. Yi, I. K. Kim, SOA-based Integrated Per- vasive Personal Health Management System using PHDs: Pervasive Computing Technol- ogies for HealthCare, 2010 4 th International Conference, pp 1-4 Session 4A 419 http://www.mercubuana.ac.id